Individual
KELLY EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.188255
OH
171M00000X
Case Manager/Care Coordinator
—
OH
324500000X
Substance Abuse Rehabilitation Facility
Primary
CDCA.188255
OH
Other
Enumeration date
11/21/2023
Last updated
05/12/2026
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